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How to talk to a woman who has problems with alcohol and other drugs

If a friend were sick, you'd do everything you could for her, wouldn't you? But when she
shows signs of having a problem with alcohol or other drugs, it's hard to know what to do or say.

Yet addiction is more than just a problem -- it's a medically-proven disease just like diabetes, cancer and heart disease -- and it's just as life-threatening if untreated.

While the symptoms of most diseases are physical, women with alcoholism and other drug problems experience emotional and social symptoms as well, often hurting their friends and families, jeopardizing their jobs and hurting themselves.While the symptoms of most diseases are physical, women with alcoholism and other drug problems experience emotional and social symptoms as well, often hurting their friends and families, jeopardizing their jobs and hurting themselves.

It's hard to be a friend to someone with a substance abuse problem, yet this is the time when she needs you most.

How to sort out your confusion about a friend's substance abuse

I don't want to hurt her feelings.
You hurt her more by staying quiet. When you talk to your friend about her drinking or drug use, you may literally be saving her life, as well as helping her get that life back together.

I don't want to ruin our friendship.
Most people feel this way and are surprised to find that just the opposite happens. In a nationwide survey of recovering people, 69% said they got help because people around them spoke up about their substance abuse; 41% said they would have gotten help sooner if someone had voiced concern.

Your friend can also have the opposite reaction, and you could lose the friendship. But if your friend continues to abuse alcohol and other drugs, you'll probably lose that friendship anyway.

If she does react badly, keep in mind that you have planted a seed of recovery that may blossom at a later date, and she will then be grateful to you for saving her life.

She doesn't do drugs; she only drinks wine.
Though legal, alcohol is a drug and for someone with the disease of addiction, it is just as devastating. In fact, many health officials believe it is the most abused drug in America. It doesn't matter if an alcoholic drinks wine, "light" beer or scotch. For her, any alcohol will cause trouble.

I'm sure her family would say something to her if it were that bad. I'm only a friend.
If your friend's drinking or drug use has gone on for some time, her family may not have noticed that it's gotten worse -- or they may have learned to ignore it to protect themselves. One of the tragedies of alcoholism and drug abuse is the incredible adjustments family members make to cope with this disease.

Also, she may hide her drinking or drug use from her family. Or, drinking or drug use is an accepted way of life in her family so that no one thinks she has a problem.

As you can see, sometimes families are the least effective in offering help. As a friend, you may have a far greater impact -- especially since most women prefer to confide in a friend when they have a problem.

Which is why this information was developed by the professional counselors at Hazelden, one of the first treatment centers dedicated solely to helping those with alcohol and other drug problems, and the first to have a separate program for women.

It outlines the symptoms of alcoholism and drug addiction so you can tell if your friend may have a problem; simple words to help you talk to her; and guidelines for getting her the assistance she needs. It is designed specifically to address the symptoms and needs of addicted women.

How to tell if your friend has a problem with alcohol or other drugs

Addiction is a confusing disease with symptoms that are sometimes contradictory. For example, if a woman gets drunk after just two drinks, her tolerance may have decreased -- a very clear symptom of alcoholism. Or that she may be drinking on top of tranquilizers or other mood-altering drugs like pain killers. Also women metabolize alcohol differently than men. For many women, 2 drinks a day, or 14 drinks a week, can indicate a serious problem. New research is uncovering ways in which a woman's body chemistry reacts differently to alcohol and drugs.

Or your friend may be able to drink large amounts of alcohol without getting drunk. This increased tolerance is also a clear symptom of alcoholism. It's not the amount of alcohol or drugs that matters; it's whether her drinking or drug use is causing her problems -- with family, friends, career, finances or legal matters.

Even if your friend appears to be highly functioning -- running a home, managing a demanding job -- she can still have a serious substance abuse problem. Help at this stage can save her considerable pain and loss since it's just a matter of time before her life falls apart.

Your friend may exhibit some of the symptoms listed below. Also watch for mood swings, any major changes in behavior, and problems that are chronic.

How to talk to your friend:

The best time to talk

If you're concerned, talk now. If you wait, it will be harder to speak up later and the more harm your friend may experience.

It's best to sit down with her the day after a drinking or drug-related incident when she's hungover and remorseful or soon after, while it's still fresh in her mind. If you can't get to her right away, that's okay too, since you're not talking about an isolated incident.

Another good time to bring up the subject is when your friend is complaining about a problem she's having. Also many women take stock of their lives around their birthdays or holidays. If she's unhappy, it's a good time to talk.

Don't try to talk to your friend when she's drunk or high, since she probably can't take in what you're saying.

But keep these key points in mind:

Everyone has different levels of friendship. Good friends, casual friends and co-workers. These suggestions will help you approach each friend in the most appropriate way:

Helping a close friend

Maureen, you're my best friend, and I love you like a sister. But I've noticed that you're drinking a lot, and I'm worried about you. You've always been there for me when I had a problem, so I'd like to help you now.

If Maureen says, "Thanks for your concern, I have been drinking more but Ive been under more pressure at work. Do you think I have a problem?"

The temptation here is to say "It's not that bad," but that won't help her. Bring up specific negative incidents that resulted from her drinking or drug use.

You can say, "I'm not a professional, so I can't tell if you have a problem. But you're drinking more -- and I think it's affecting you. Remember Colleen's wedding when you started crying uncontrollably at the table? Or the night you called me at 1 a.m., and didn't remember the next day? You might go for a professional assessment to find out if drinking is the problem, or if it's something else."

Helping a casual friend

Nancy, it's great having lunch with you after the kids' play group. But I'm concerned about the amount you drink at lunch. You seem unfocused when you leave, and I'm afraid for you and the kids when you get in the car. I wanted to bring this up before anything bad happens.

If Nancy says, "I know I'm a terrible mother to drive after I've been drinking. But the kids are driving me crazy, and my husband works late every night. The only time I get to relax is at our lunch or when I take a tranquilizer. I wish I could be more like you -- so in control of everything."

You can say, "If you're drinking because you're depressed, you may be making yourself even more unhappy. Alcohol and tranquilizers are depressants. And you're putting yourself and your kids in jeopardy by driving after you've been drinking. If you're having trouble coping, why not make an appointment to get professional help. I'd be happy to go with you if you'd like some support."

Helping a Co-Worker

Holly, you're one of the brightest women I know. But you've been missing work and coming in late. My report was late because I didn't have your input. I'm concerned about you. You don't seem to be yourself. I know you've been partying a lot and I wonder if that was the reason. If you're having problems, I'd be happy to listen and help you get whatever help you need.

If Holly says, "My private life is none of your business. I'm entitled to use my sick days when I need them. I'm sorry your report was late, but that happens sometimes. So I'd appreciate it if you'd stay out of my personal life. I know we're friends, but you've stepped out of bounds."

If she tries to use anger to intimidate you, she's just being defensive. Stay firm and calmly voice your concern. One of the symptoms of substance abuse is anger at those who comment on it.

You can say, "I'm sorry that you think that I'm interfering, but I'm concerned about you. I wanted to talk to you privately before it becomes an even bigger issue. If you need help I'm here for you. I value your friendship and will do whatever I can." Of course, your friend can respond any number of ways. Just listen, stick to the facts, show a caring attitude, and offer to help.

What to do if your friend isn't ready for help

Denying that she has a problem with drinking or drugs is one of the unfortunate symptoms of this disease. Don't take it personally. The only thing you can do is back off, and let her know that when she's ready for help, you'll be there for her.

Don't despair, even if she responds with anger, or harsh words. You have taken a very loving and courageous action -- one that may save her life down the road.

Stay in touch, letting her know you care. It may take several attempts by you before she gets help. But if she wants to meet only in bars, or at social occasions where she can drink, suggest other plans. Don't offer her alcohol when she visits. Don't lend her money. Don't accept late night calls when she's drunk or high. By changing the way you act in the friendship, you'll reinforce your words with actions she's sure to notice.

And if she is ready

Your friend may have secretly hoped someone would notice and help. And there's considerable help available.

Founded in 1935, Alcoholics Anonymous (AA) has helped millions achieve sobriety. There is also Narcotics Anonymous (NA). Both groups will likely have meetings in your area. AA is listed in most phone books and sponsors meetings for women only. Offer to drive her to a meeting. Better yet, if you have a friend in one of these programs, solicit her help, and introduce them.

Look into places where she can get a professional assessment, as well as available treatment centers. That way, you can have the information handy if your friend or the professional she consults thinks she needs outpatient or residential care. If she decides to go to a treatment center, offer to sit with her while she makes the call; if possible, take her to the center.

One reason a woman hesitates to enter a treatment center or go to AA or NA meetings is that on top of feeling guilty about her drinking, she will also feel guilty about taking time for herself and spending less time with her children. Point out that most treatment programs are only a few weeks and that support group meetings are only an hour. By taking a little time to recover, she'll be more available to her family.

If your friend is a career woman who is afraid to take time away from work, help her see that, at the rate she's going, she wont achieve her career goals. By taking the time to get better, she'll be better able to handle her job and clear up any problems associated with it.

How your friend's recovery process can affect your relationship

During the next couple of months, your friend will go through a lot of changes. Because of the stigma of alcoholism and drug abuse, she may experience grief and shame -- causing her to withdraw. She may prefer spending her time at support group meetings and making new friends who are also in recovery. It can hurt to feel like youre losing a friend -- especially one you went out of the way to help. But over time, most recovering people resume their former friendships -- and bring more to them than ever before.

Meanwhile, you can feel good knowing that you took the actions a good friend should take. You may have saved her life and definitely have made it worth living again.

If you live with or are emotionally involved with someone who abuses alcohol or other drugs

This can be difficult, heart-breaking or even a dangerous experience. Take care of yourself. Don't handle it alone. You can get support at Al-Anon Family Group listed in your phone book. In addition, many treatment centers and substance abuse professionals have special programs for friends and family members.

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